Tuesday 6^th October 2009

New telehealth treatment pathway for stroke patients

NHS Western Isles recently launched a Stroke Thrombolysis service as one of the Clinical Strategy ‘early deliverables’. This is a significant development as it allows stroke patients to receive a standard of care previously only available in larger stroke units.

The development is part of the Scottish Telestroke Programme facilitated by the Scottish Centre for Telehealth and the stroke managed clinical networks across Scotland.  Chest Heart and Stroke Scotland are funding the evaluation of the Programme. (For more information go to: www.sct.scot.nhs.uk/telestroke.html )

Stroke Thrombolysis is a treatment for breaking up clots and is available to patients with ischaemic stroke. All patients presenting with symptoms consistent with new onset stroke of less than 4.5 hour duration are considered for treatment.  The treatment involves the administration of a ‘clot-busting drug’. If administered within a 4.5 hour timeframe there is a one in seven greater chance of living independently. This is improved to a one in two greater chance if administration of the clot busting drug can be performed within one hour of the onset of symptoms

NHS Western Isles Coronary Heart Disease and Stroke Managed Clinical Network Co-ordinator, Donella Campbell explained: “As stroke is a medical emergency, ambulance personnel radio in to the Accident and Emergency Department that they have a patient with symptoms consistent with new onset stroke.

“A&E then page the on-call Stroke Consultant at Aberdeen Royal Infirmary and the on-call local radiographer in order to arrange an urgent CT scan. The patient returns to A&E following the scan. If the scan and observations show the patient may be eligible for the clot busting drug the patient has a video consultation with the consultant and is able to view everything that is happening via a telehealth monitor. The consultant is also able to speak to relatives or carers at the same time. A specialist decision on treatment can then be made.

“A&E staff and ambulance staff have had training on stroke thrombolysis and this is ongoing. In addition, staff in primary care are being made aware of the new service and the changes it means for the response to a new stroke in the community.”

Photo 1: Pictured are those who attended the launch of the service in the Western Isles: NHS Western Isles Coronary Heart Disease and Stroke Managed Clinical Network Co-ordinator, Donella Campbell; Elaine Macleod, Emergency Nurse Practitioner, NHS Western Isles; Dr David Rigby, Chair of the Stroke Managed Clinical Network; Jane Ferguson, Radiographer, NHS Western Isles; Janette Murray, Staff Nurse, NHS Western Isles; Chris McLachlan, Patient Services Officer, NHS Western Isles (volunteer ‘patient’); Anne Duthie, Telestroke Programme Manager, Scottish Centre for Telehealth; Interim Hospital Lead, NHS Western Isles, Chrisanne Campbell; Senior Charge Nurse, Erisort Ward, NHS Western Isles, Joan Frieslick; and Dr Jim Ward, Medical Director, NHS Western Isles.

Photo 2: The link up to Aberdeen Royal Infirmary.